Individual provider Active NPI

Larissa Nadia Larsen, M.D.

  • Dermatology Physician
  • Ventura, CA
National Provider Identifier
1063733426
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A118359 Issued in CA
Practice address
6633 Telephone Rd Ste 100
Ventura, CA 93003-5569
Phone
(310) 644-9121
NPI assigned
Jun 18, 2010
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A118359 CA Primary

Addresses

Primary practice location

6633 Telephone Rd Ste 100
Ventura, CA 93003-5569

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631
Phone (310) 301-8707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140805002621 CA Practitioner - Dermatology 0840417473 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

100 Moody CT
Suite 200
Thousand Oaks, CA 91360-6082
Phone (805) 418-3500

2020 Santa Monica Blvd
Santa Monica, CA 90404-2131

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

6633 Telephone Rd
Ventura, CA 93003-5569

Merit-based Incentive Payment System (MIPS)

Final score
87.51 of 100Reported as group
Quality
79.37
Promoting interoperability
100
Improvement activities
40
Cost
73.65

Merit-based Incentive Payment System (MIPS)

Final score
85.34 of 100Reported as group
Quality
90.85
Promoting interoperability
87
Improvement activities
40
Cost
71.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision18
Removal of skin lesions1341
Removal or shaving of skin growth1-10
Skin biopsy305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic Current Accepting new patients
Larissa Larsen Dermatology Inc Dermatology Current Accepting new patients
Venice Family Clinic Current Accepting new patients
The Regents of the University of California CurrentSince Jan 1, 2024 Accepting new patients
Venice Family Clinic CurrentSince Dec 9, 2025 Accepting new patients
Venice Family Clinic Current Accepting new patients
Daniel Gene Kolder, M.D. a California Professional Corporation CurrentSince Nov 1, 2018 Accepting new patients
Venice Family Clinic CurrentSince Dec 9, 2025 Accepting new patients
The Regents of the University of California CurrentSince Jan 1, 2024 Accepting new patients
Csi Medical Group Dermatology CurrentSince Aug 1, 2023 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Regents of the University of California Past Accepting new patients
County of Ventura Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

2438 N Ponderosa Dr
Ste C105
Camarillo, CA 93010
Phone (805) 308-2068

2460 N Ponderosa Dr
Ste A117
Camarillo, CA 93010
Phone (805) 430-0002

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

File 55737
Los Angeles, CA 90074

1700 N Rose Ave
Ste 450
Oxnard, CA 93030
Phone (805) 201-2821

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

4201 Torrance Blvd
Ste 640
Torrance, CA 90503
Phone (310) 375-9994

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630

6633 Telephone Rd
Ste 100
Ventura, CA 93003
Phone (805) 644-9121

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: llarsen@directaddress.net
  • Direct secure messaging: llarsen1225713@direct.uclahealth.org

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1063733426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6633 TELEPHONE RD STE 100",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035569",
            "telephone_number": "310-644-9121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "LARISSA",
        "middle_name": "NADIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A118359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.